Operating an emergency room (ER) 24 hours a day, seven days a week generates an annual loss of more than $2 million for Winneshiek Medical Center (WMC), according to Gretchen Dahlen, WMC chief administrative officer.

Because it's a community hospital, WMC accepts all patients to the emergency room - regardless of their ability to pay. WMC levied $436,417 in property taxes for the hospital last year - the fifth lowest levy for a community hospital in Iowa - which offsets that ER loss by about 19.7 percent, she said.

WMC is the second largest critical access hospital in Iowa.

"The county tax subsidy is very worthwhile. It provides care for about 11,000 (ER) patients (annually)," she told the WMC Board of Trustees Wednesday evening.

The emergency room, ambulance and urgent care are "high dollar services" totaling $4,831,788 for the past fiscal year, Dahlen said. However, after contractual adjustments, bad debt and charity care, the hospital only receives $2,613,618 for those services.

"Winneshiek Medical Center will continue to provide 24/7 emergency care through our emergency room, urgent care and ambulance service; however, we prefer not to raise county taxes to fund this service. Rather, Winneshiek Medical Center tries to make up for these losses other ways, which is why we so heavily rely on income from our clinic, specialist services - ear nose, throat, orthopedic and urology, MRI, CT and others," Dahlen said.

"Community support of money-making services allows us to keep our emergency room open and at the level of service Winneshiek County citizens are used to and expect," she said.

Board member Arlene Houlihan asked when the county tax rate was last raised. Dave Rooney, WMC senior director of clinics and outreach, said it was in the early 1990s.